Clinical chronopharmacology. Circadian rhythms in the functions of the human body and their role in rational pharmacotherapy.

Question 1

what is the circadian rythm

Answer 1

physical, mental, and behavioral changes that follow a daily 24h cycle

determining the sleeping and feeding patterns of all animals, including human beings.

Question 2

exogenous factors affecting circ rythm

Answer 2

sunlight

temp

Question 3

endogenous factors affecting circ rythm

Answer 3

Brain wave activity
Hormone production
Cell regeneration
Core body temperature

Question 4

where is the circadian rythm regulated

Answer 4

suprachiasmatic nucleus in the hypothalamus

Question 5

how is the circ regulated

Answer 5

1) SCN interprets day/night legth from retina and interprets it
2) sends signals to Pineal gland about day/night length
3) pineal gland produces melatonin which peaks at night and is low at daytime

Question 6

circadian rythm markers

Answer 6

melatonin lvls

core body temp

CORTISOL plasma lvl

Question 7

factors disrupting circ rythm

Answer 7

Change of day and night
Change of seasons - spring, summer, autumn and winter
The location of planets
Geomagnetic storms
Travel across time zones
bipolar disorder delayed sleep phase disorder

Question 8

negative effeects of disturbed cirrcadian rythm

Answer 8

short term

• insomnia
• fatigue
• disorientation

long term

• cvd
• depression

Question 9

what is chronotherapeutics

Answer 9

use of circadian or other rhythmic cycles of a condition’s symptoms and/or of the individual being treated in the application of therapy.

Question 10

why is chronotherapeutics effective

Answer 10

Drugs change their power in the course of the 24h period of application.

Question 11

which four factors determine the timing of drug use in chronotherapeutics (4)

Answer 11

chronophK of drug
chronophD PF DRUG
CIRC rythm of organ systrms
circ rythm of disease

Question 12

circ rythm of disease in

Answer 12

⦁ Angina
⦁ Myocardial infarction
⦁ Sudden arrhythmic death
have higher risk in morning

Question 13

timing of drugs in CVD

Answer 13

retard drugs in evening

drugs in morning

Question 14

when should the highest dose be admin in CVD

Answer 14

morning as they have their highest resorption

Question 15

which drugs are better absorbed in morning in CVD

Answer 15

bb

Question 16

what time of day has high risk of asthma exacerbation

Answer 16

morning

Question 17

which releiver has best absorbtion in morninf

Answer 17

theophyline

retard forms prescribed in evenings

Question 18

when are beta agonists prescribed in respiratrory diseeases

Answer 18

evening

Question 19

when is gastric acidity highest

Answer 19

evening

Question 20

when are high dose H2 blockers prescribeed

Answer 20

evening as absorption is slower and effect lasts longer

Question 21

when are thte mazimum levels of cortisol

Answer 21

6-8am

3pm

Question 22

in hypocorticism when are glucocorticoids prescribed for substitutional therapy

Answer 22

2/3 in morning

1/3 in afternoon

Question 23

when are NSAIDS least ulcerogenic

Answer 23

evening after meals

Question 24

time of aspirin admin fpr prophylaxis of ischemic heart disease

Answer 24

evening